From optimism to disillusion about commitment to transparency in the medico-industrial complex

In the mid-1970s, I was involved with others in trying to assemble evidence about the effects of care during pregnancy and childbirth. We started by searching Medline to identify reports of controlled trials that we thought might be sufficiently reliable to be taken into account in our analyses; and then searched about 70 journals by hand, page by page, back to the issues published in 1950. We found about 3500 reports of controlled trials and, with help from the World Health Organization, we published the references to these in a classified bibliography in the mid-1980s.1 But then we thought, ‘What about trials that don’t get published? If we don’t take those into account, we might reach biased conclusions’. We knew of anecdotes about researchers who had had disappointing results of trials, and